Monday, 24 September, 2018

Study says not all breast cancer patients need chemotherapy

Pancreatic cancer patients could live more than twice as long if given chemotherapy and radiation treatment before surgery Pancreatic cancer patients could live more than twice as long if given chemotherapy and radiation treatment before surgery
Samantha Long | 08 June, 2018, 00:15

The researchers said ongoing clinical trials are obtaining additional information on the clinical usefulness of the 21-gene assay in women with hormone receptor-positive breast cancer and positive axillary nodes, and evaluating the clinical usefulness of the 50-gene assay in this context.

The new results demonstrate that chemotherapy is not beneficial for most women in the intermediate-risk group.

Cancer care has been evolving away from chemotherapy - older drugs with harsh side effects - in favor of gene-targeting therapies, hormone blockers and immune system treatments.

However an estimated 25% of patients stop within two years because they can not endure the side effects, lead author Dr Sherry Shen, of the New York Presbyterian Hospital, said.

Dr Epstein, a clinical oncologist at Memorial Sloan Kettering Cancer Centre in NY, said the two studies show "the anti-inflammatory benefits of a relatively cheap, well-tolerated supplement".

Although the new findings are extremely promising for women who have early-stage breast cancer, the conclusions may not apply to those who have larger tumors or those battling cancer that has spread throughout the body.

Approximately 17 percent of girls needed high-risk scores and have been counseled to have chemo.

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Care in cancer isn't a one size fits all, so even though this study has been labeled a breakthrough, Dr. Schmidt says its important to discuss all options and the study criteria with an oncologist. Women are given scores based on this test, classifying them as being either at high risk of recurrence, intermediate risk, or low risk.

The study was funded by the National Cancer Institute, some foundations and proceeds from the US breast cancer postage stamp. "You're never going to see these kinds of trials from the drug companies", because what is being tested might result in less use of their products, Brawley said.

Testing solved a big problem of figuring out who needs chemo, said Dr. Harold Burstein of the Dana-Farber Cancer Institute in Boston.

After undergoing surgery and radiation, the women randomly received either chemotherapy plus endocrine therapy or endocrine therapy alone.

Dr. Lisa Carey, a breast specialist at the University of North Carolina's Lineberger Comprehensive Cancer Center, said she would be very comfortable advising patients to skip chemo if they were like those in the study who did not benefit from it.

Dr. Newman said there is one caveat. "Towards the end, my eyes would water", she said. She said, "I was in the grey area".

"I was somewhat relieved". "I'm a firm believer in medical research".

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